Gastrointestinal anastomosis as a disease

If the gastrointestinal anastomosis, imposed with a therapeutic purpose in case of gastric ulcer, leads to ulcer healing and subsequently becomes unnecessary and disrupts normal physiological relations, or if this anastomosis is imposed for incorrect indications (for example, with an ulcerative symptom complex without an ulcer or gastroptosis), then painful phenomena occur, which are based on the anastomosis itself; these cases Pribram (1929) singled out into a separate nosological unit - "gastrointestinal anastomosis as a disease". The essence of the disease is reduced mainly to stagnation in the leading loop of the anastomosis; therefore, it usually occurs with a posterior anastomosis, when this stagnation is possible, and never occurs with an anterior anastomosis with Brown's enteroenteroanastomosis, when stagnation in the adductor loop is excluded. This stagnation in the adductor loop of alkaline contents leads to a reflex stimulating effect on the fundic glands of the stomach and inhibits gastric evacuation; as a result, in 3-4 hours after a meal, late gastro-succorrhea occurs. Thus, both mechanical moments and reflex disorders on the part of the pylorus and duodenum are important in the origin of the disease.